St John's wort, a herb used for thousands of years to treat nervous complaints, has been found to be just as effective in treating mild to moderate depression as a leading antidepressant drug.

Hippocrates, Pliny and Galen all described St John's wort, which has the Latin name hypericum perforatum, as a treatment against possession by demons in ancient Greece.

It is available over the counter in high street pharmacies. A paper in the British Medical Journal says doctors should give it to depressed patients in preference to imipramine, the most commonly used tricyclic antidepressant medicine.

There have been small studies of St John's wort's effect on depression before, but this research compared the herb with the full dose of imipramine that would normally be prescribed for mild to moderate depression.

The study involved 324 out patients at 40 clinics in Germany, half of whom were given St John's wort and half the antidepressant. The patients did not know which they were receiving. Their decreasing depression was measured using standard psychiatric tests.

The scientists, led by Helmut Woelk, medical director of the Akademisches Lehrkrankenhaus der University Giessen, found that St John's wort was just as effective in alleviating the depression of the patients as was the conventional drug, with fewer side-effects.

"In view of the mounting evidence of hypericum's comparable efficacy to other antidepressants and its safety record, hypericum should be considered for first line treatment in mild to moderate depression," they write.

There may be reluctance among some GPs in the UK to begin prescribing a herbal medicine in preference to tricyclic antidepressants, but there is likely to be enthusiasm among patients. Herbal medicines have become increasingly popular, causing concern in medical circles because herbs can interact with conventional medicines. Patients who take them often do not tell the doctor, either because they do not see the need or for fear of scorn.

There have been warnings that St John's wort can affect transplant patients by countering the anti-rejection drug cyclosporin. The medicines control agency has also warned that the herb can interfere with the contraceptive pill.

The study found, however, that taken by itself for depression, it did not cause the side-effects typical of the tricyclics - dry mouth, sweating, dizziness, nausea, asthenia and headache.

In the imipramine group, 41 (25%) had one or more of these side-effects. In the St John's wort group, 13 (8%) reported side effects, the most common of which was a dry mouth. Four patients on St John's wort dropped out of the study because of side-effects, compared with 26 on imipramine.

The biggest worry over the tricyclic antidepressants is the possibility of fatal overdose. The Prozac class of drugs, selective serotonin reuptake inhibitors (SSRIs), have become more popular because there is no such risk, but there have been other concerns about their safety.

The report says: "Patients seen in general practice frequently prefer to bear the symptoms of depression rather than sustain the side-effects of treatment with antidepressants. An effective antidepressant with no (or comparatively few) side effects would be an optimal treatment. Hypericum seems to meet these criteria."

Alternative cures

Herbal medicine aficionados say thousands of years of use prove effectiveness; doctors demand scientific proof. Few clinical trials have been done, but some herbs have shown promising results

Garlic Shown to reduce high blood pressure

Gingko biloba The leaves of this Chinese tree are used to improve blood circulation to the brain, improving memory - possibly for Alzheimer's sufferers

Hawthorn Popular in the middle ages, berries are used to increase blood flow to the heart, reducing angina symptoms

Saw palmetto North American berries. A small study has shown they can shrink a benign prostate swelling

Valerian Used as a sedative since Roman times.
　　

(From HealthWorld Online)